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West Michigan employers have started to adjust their operations in response to the Patient Protection and Affordable Care Act, according to an annual report from Grand Valley State University. The Health Check report suggests the federal health reform law drove up the use of workplace wellness, premium cost-sharing and high-deductible health plans.

"There's a lot of uncertainty (about the ACA), and uncertainty leads to more conservative business decisions," said Paul Isely, an economics professor at GVSU's Seidman College of Business and a report co-author.

Among the results from the survey, to which 168 employers responded:

• 40 percent were considering passing along to employees the costs of adhering to mandates in the law, and 48 percent said they already had.

• About 81 percent offered employee health coverage for 2014. Just 60 percent said they intend to continue offering coverage in 2015, when a $2,000-per-employee penalty takes effect for employers with 50 or more full-time employees that do not offer coverage.